The report published by the Health Inspectorate following its announced inspection of Monklands Hospital was a sobering read.
Although the report highlights some areas of strength, it also identifies significant shortcomings, including:
- A lack of training with moving and assisting patients, with examples of patients being “heaved” and “pulled” up the bed. Records show that staff had not received the appropriate “mandatory” training since 2010.
- Non-compliance with the national policy on Do not attempt Cardiopulmonary Resuscitation (DNACRR), with nurses in one ward uncertain as to which patients were identified as not for resuscitation. Confusion arose after patients were moved between rooms.
- A failure to ensure that all older patients admitted are screened and assessed for cognitive impairment, an inconsistent approach to implementing and following care plans for those patients assessed as cognitively impaired, and no reliable system to monitor the number of bed or ward moves (“boarding”) patients with dementia are subjected to.
Of the issues highlighted, the most eye-catching is the confusion regarding which patients are classified as Do Not Resucitate. There are national guidelines in place to ensure that confusion does not arise, and it is the responsbility of senior staff and management to ensure that these guidelines are complied with at all times.
The lack of training afforded to nurses in moving and assisting patients is also worrying. It is vital that nurses know how to move patients without causing unnecessary injury or indignity.
Finally, and as the report makes clear, all older patients admitted to Monklands must receive the appropriate screenings. Being in the unfamiliar environment of a hospital can be disorientating and distressing under normal circumstances, and these feelings are likely to be accentuated where the patient is suffering from some form of dementia or cognitive impairment. For this reason, it is also important that the practice of “boarding” (moving patients around different wards to free up capacity) is kept to an absolute minimum, or abandoned altogether.
It is absolutely not my intention to cast aspersions on the hard working clinical staff at Monklands. In common with hospitals across Scotland, Monklands has suffered from five years of Scottish Government cuts to its budget and frontline staff. It is clear that these cuts are having an adverse upon upon morale, training and standards.
The vast majority of staff at Monklands are doing an excellent job under difficult circumstances. However, in order to provide first class care, they must receive appropriate support and guidance from the Scottish Government.
Nicola Sturgeon says she is protecting the NHS. The evidence says otherwise.
Over the past few weeks, I have been struck by the number of constituents, in Central Scotland and elsewhere, who have expressed real concern about the provision of bus services within local communities.
Studies have shown that bus journey’s account for approximately 85% of all public transport journeys taken in Scotland, and that access to local bus services is especially crucial for the elderly and those on low incomes.
I recently visited a group of constituents in Airdrie whose travel opportunities are limited by irregular service along daytime routes, and scant provision of evening bus servies. They also expressed concern about recent price rises along certain routes.
That is why the decision by the SNP Government to cut the Bus Services Operators’ Grant by 20%, and to change the way in which it is calculated, is so misguided. Formerly, the grant was calculated accorded to fuel expenditure; now, following the recent rise in fuel duty and prices (average diseal prices increased by 14.7% last year), the grant will be calculated according to mileage.
In addition to this, the Scottish Government’s decision to impose a cap on the National Concessionary Travel Scheme will place further pressure on bus operators, especially given that current projections suggest that this year’s scheme will exceed the £180 million budget by around £6 million.
I and my Labour colleagues believe that the Scottish Government should be investing in the public transport infrastructure. Instead, it has chosen to reduce a grant that helps to maintain local services and prevents fares from escalating.
Sadly, it is likely to be passengers that bear the brunt of the SNP’s folly, and that is why Scottish Labour is backing the numerous campaigns that have sprung up throughout Scotland to support local bus services and condemn SNP cuts.